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Utility of Waist-To-Height Ratio in Detecting Central Obesity and Related Adverse Cardiovascular Risk Profile Among Normal Weight Younger Adults (from the Bogalusa Heart Study)

https://doi.org/10.1016/j.amjcard.2009.04.037Get rights and content

Data on the utility of the waist-to-height ratio in detecting central obesity and related cardiovascular risk among normal weight younger adults are scant. This aspect was examined in 639 normal weight (body mass index 18.5 to 24.9 kg/m2) black and white adults (75% white and 36% men) 20 to 44 years old. The subjects with a waist-to-height ratio ≥0.5 were grouped as having central obesity normal weight, with the rest considered the control group. The subjects with central obesity, compared to the controls, after adjusting for age, race, and gender, had significantly greater diastolic blood pressure, mean arterial pressure, low-density lipoprotein cholesterol level, triglycerides, triglycerides/high-density lipoprotein cholesterol ratio, insulin, homeostasis model assessment of insulin resistance, uric acid, C-reactive protein, and liver function enzymes (alanine aminotransferase and γ-glutamyl transferase). On multivariate analysis, the central obesity group compared to the control group was 1.9, 2.2, 2.9, and 2.5 times more likely to have significantly adverse levels (top tertile vs the rest) of mean arterial pressure, triglycerides/high-density lipoprotein cholesterol ratio, homeostasis model assessment of insulin resistance, and C-reactive protein, respectively. The central obesity group also had a greater prevalence of dyslipidemia, hypertension, insulin resistance, hyperuricemia, and elevated C-reactive protein. The age-, race-, and gender-adjusted mean value of the common carotid intima-media thickness, a measure of subclinical atherosclerosis, was greater in the central obesity group compared to the control group (0.76 vs 0.71 mm, p = 0.009). In conclusion, these findings underscore the utility of the waist-to-height ratio in detecting central obesity and related adverse cardiovascular risk among normal weight younger adults.

Section snippets

Methods

The Bogalusa Heart Study is a biracial (65% white, 35% black) community-based study of the natural history of cardiovascular disease since childhood.5 The present study sample was derived from a cohort of 2,065 subjects (70% white and 42% men) 20 to 44 years old who were examined as a part of a longitudinal follow-up survey. The participants (n = 639) with a body mass index of 18.5 to 24.9 kg/m2 were considered of normal weight and included in the present study. Using the previously recommended

Results

As listed in Table 1, the normal weight subjects (n = 639) constituted 30.9% of the total cohort. Of these, 65 normal weight subjects (10.2%) had central obesity (waist-to-height ratio ≥0.5). The central obesity normal weight group, in addition to being relatively older, had significantly more men than women, and, after adjusting for age, race, and gender, had greater levels of diastolic blood pressure, mean arterial pressure, low-density lipoprotein cholesterol, triglycerides,

Discussion

The present community-based study used the waist-to-height ratio as a simple anthropometric measure of central (visceral) obesity in normal weight persons and found that normal weight subjects with central obesity were characterized by an increased mean arterial pressure, triglyceride/HDL cholesterol ratio, insulin resistance as shown by the HOMA-IR, and CRP compared to normal weight persons without central obesity. In addition, they had an excess carotid intima-media thickness, a validated

Acknowledgment

The Bogalusa Heart Study was a joint effort of many investigators and staff members whose contributions are gratefully acknowledged. We especially thank the study participants.

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    This study was supported by Grant AG-16592 from the National Institute on Aging, Bethesda, Maryland, and Grants 0855082E and 0555168B from the American Heart Association, Dallas, Texas.

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